Inhibition of Na,K-ATPase ␣2 isoforms in the human heart is supposed to be involved in the inotropic effect of cardiac glycosides, whereas inhibition of ␣1 isoforms may be responsible for their toxic effects. Human Na,K-ATPase ␣1 and ␣2 isoforms exhibit a high ouabain affinity but significantly differ in the ouabain association and dissociation rates. To identify the structural determinants that are involved in these differences, we have prepared chimeras between human ␣1 and ␣2 isoforms and ␣2 mutants in which nonconserved amino acids were exchanged with those of the ␣1 isoform, expressed these constructs in Xenopus laevis oocytes, and measured their ouabain binding kinetics. Our results show that replacement of Met 119 and Ser 124 in the M1-M2 extracellular loop of the ␣2 isoform by the corresponding Thr 119 and Gln 124 of the ␣1 isoform shifts both the fast ouabain association and dissociation rates of the ␣2 isoform to the slow ouabain binding kinetics of the ␣1 isoform. The amino acids at position 119 and 124 cooperate with the M7-M8 hairpin and are also responsible for the small differences in the ouabain affinity of the ouabainsensitive ␣1 and ␣2 isoforms. Thus, we have identified new structural determinants in the Na,K-ATPase ␣-subunit that are involved in ouabain binding and probably control, in an ␣ isoform-specific way, the access and release of ouabain to and from its binding site.